COVID Vaccines: Approaches to vaccine trial design
COVID Vaccines: Approaches to vaccine trial design
November 4, 2020
Christine Grady Department of Bioethics Clinical Center | National Institutes of Health
These are my views, and do not represent those of the NIH, DHHS, or the US government.
BIOETHICS AT THE NIH
Plan
? Vaccine research ? Ethical challenges in vaccine trials ? Approaches to testing a SARS CoV-2/COVID-19 vaccine ? Current status/ COVID-19 vaccine landscape
BIOETHICS AT THE NIH
Vaccines
? "With the exception of safe water, no other modality, not even antibiotics, has had such a major effect on mortality reduction..."
? Since 2000? Deaths in children < 5yo reduced (Millennium Development Goals) ? More children reached than ever before (>100 million in 2005-07) ? More vaccines available and more lives saved in developing countries ? More money available through innovative funding mechanisms ? Most productive decade in history of vaccine development ? Global vaccine market has tripled, vaccine industry one of fastest growing sectors of industry
WHO, UNICEF, and the World Bank. State of the world's vaccines and immunization, 3rd Ed. Geneva, WHO, 2009
BIOETHICS AT THE NIH
Plotkin S. Vaccines we Need but Don't Have. Viral Immunology 2018
One of the brightest chapters in the history of science is the impact of vaccines on human longevity and health."(S Plotkin, 2014
Vaccines
? Substantial contributions to global public health, but always controversial
? Disturbing the natural order ? Safety and untoward effects ? Public good versus individual rights ? Uneven access ?...
BIOETHICS AT THE NIH
The paradox of vaccines
Vaccine risk
Vaccine success
BIOETHICS AT THE NIH
Vaccines
? Many ethical challenges:
? Development and testing of vaccines ? Distribution/allocation of vaccines ? Public health use of vaccines ? Social acceptability of vaccines ? Vaccine related injury and compensation ? Anti- vax movement ? Etc.
BIOETHICS AT THE NIH
Vaccines
? Many ethical challenges:
? Development and testing of vaccines ? Distribution of vaccines ? Public health use of vaccines ? Untoward effects ? Social acceptability of vaccines ? Allocation ? Etc.
BIOETHICS AT THE NIH
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